‘My Eyes Were So Puffy I Couldn’t Even Open Them’

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to drain bodily fluid has been reduced.” Though research into the area is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they pose. “Many surgeons don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|